Decreasing Rates of Fracture-Related Hospitalization With Primary Biliary Cholangitis: Insights From the Nationwide Inpatient Sample.

Introduction Primary biliary cholangitis (PBC) is associated with an increased risk of developing fractures. Current guidelines recommend measures that can help prevent the development of fractures in these patients. The purpose of this study was to trend the rates of hospitalizations related to fractures and their burden on healthcare.

A Safety Comparison of Single-Agent Methohexital, Ketamine, or Propofol for Musculoskeletal Procedural Sedation in the Emergency Department.

Background: The use of sedative and analgesic agents is required for procedural sedation in the emergency department (ED). Agents such as ketamine and propofol are commonly used for procedural sedation. This is likely due to clinical experience with these agents, as well as optimal pharmacologic properties when used in combination with one another.

Outcomes of dual kidney transplants from high KDPI kidneys are superior compared to single kidney high KDPI transplants at 1 year.

Dual kidney transplantation (DKT), utilizing two adult kidneys from the same donor for one recipient, has been used as a way to expand the available donor pool. These kidneys often come from high Kidney Donor Profile Index donors (KDPI > 85%). Data comparing outcomes between high KDPI DKT and single kidney transplants (SKT) remain limited.

COVID-19 mortality is associated with pre-existing impaired innate immunity in health conditions.

COVID-19 can be life-threatening to individuals with chronic diseases. To prevent severe outcomes, it is critical that we comprehend pre-existing molecular abnormalities found in common health conditions that predispose patients to poor prognoses. In this study, we focused on 14 pre-existing health conditions for which increased hazard ratios of COVID-19 mortality have been documented.

Blunt traumatic posterior cord syndrome.

Introduction: Posterior cord syndrome (PCS) is rare and insufficiently assessed in the International Standards for Neurological Classification of Spinal Cord Injury (ISNCSCI).

Case Presentation: A 39-year-old male was involved in a motorcycle collision and presented with paresthesia of the entire body, neck pain, subjective right arm weakness, and loss of position sense in all extremities. Imaging of the cervical spine revealed fractures of the upper cervical spine including a teardrop fracture and hangman fracture.

Characterization of Emergency Department Rabies Post-Exposure Prophylaxis Procedures with an Infectious Diseases Clinic Referral Process.

Rabies post-exposure prophylaxis (rPEP) in the emergency department (ED) is associated with high costs, complicated administration protocols, and a time-sensitive vaccination series that often requires ED follow-up visits for subsequent vaccine administration. This study sought to characterize the number of redirected vaccine administrations in those patients referred to ID Clinic, guideline compliance, and opportunities for improvement. Retrospective chart review of adult and pediatric patients presenting to the ED from 2016 to 2019 and prescribed rabies immunoglobulin.

Brown-Sequard syndrome associated with hangman fracture after blunt trauma: A case report.

Background: The association of Brown-Sequard syndrome (BSS) and hangman fracture (HF) is rarely reported.

Case Description: We present a case of a 28-year-old female with a HF sustained after a motor vehicle accident and BSS. Diagnosis was established based on typical loass of motor function ipsilaterally and loss of pain and temperature sensation contralaterally.

Alcohol Withdrawal Syndrome in Women vs Men: Analysis of 1496 Cases at a Single Site.

Background: Studies of alcohol withdrawal syndrome indicate a higher prevalence in men than in women. However, it is unknown how the condition differs between the sexes.

Objective: To assess alcohol withdrawal syndrome in women versus men at a single site.

Opioid-Free Anesthesia and Certified Registered Nurse Anesthetists: Barriers to Implementation.

While knowledge surrounding opioid-free anesthesia (OFA) has increased in current literature, there is an absence of research specific to nurse anesthesia practice. This study aimed to identify the number of surveyed Certified Registered Nurse Anesthetists (CRNAs) who incorporated OFA into practice and uncovered barriers to its implementation. This quantitative survey solicited data from 2,883 CRNAs across the United States.

Outcomes and resource utilization in calcium pyrophosphate deposition disease patients who underwent total knee arthroplasty: a cross-sectional analysis.

This cross-sectional study aims to evaluate the predictors, outcomes, and resource utilization of total knee arthroplasty (TKA) in calcium pyrophosphate deposition disease (CPPD) patients. We used the US National Inpatient Sample database to identify CPPD and non-CPPD who underwent TKA from 2006 to 2014. Data collection included patient demographics and comorbidities.

Factors Associated with Survival of Hepatocellular Carcinoma (HCC) Patients at a Safety Net Hospital in Arizona without On-Site Liver Transplant Program.

Background: With the rising incidence of hepatocellular carcinoma (HCC), ongoing efforts should be focused on providing equitable and state-of-the-art care to patients.

Purpose: The aim of this study was to determine the survival of patients with HCC seen at a high-proportion Safety Net Hospital (h-SNH), where loco-regional therapy and hepatology services are available and liver transplantation (LT) is referred to outside facilities.

Patients And Methods: A retrospective cohort study was conducted on all patients with HCC seen at Valley Wise Health Center (VWHC) over a ten-year period.

Important Nematodes in Children.

Intestinal nematode infections caused by soil-transmitted helminths (STH), such as the roundworm Ascaris lumbricoides, the whipworm Trichuris trichiura, and the hookworms Ancylostoma duodenale, and Necator americanus, infect more than 1 billion people throughout the world. School-aged children tend to harbor the greatest numbers of intestinal worms, and as a result, experience more adverse health consequences, such as poor growth, anemia, and cognitive decline. Clinicians should maintain a high degree of suspicion in endemic areas when patients present with surgical abdomens, particularly children.

Impact of SARS-CoV-2 infection and implementation of infection prevention and control (IPC) measures on inpatient psychiatric units.

Psychiatric inpatients are at high risk of acquiring and transmitting communicable diseases such as SARS-CoV-2 (COVID-19). Via chart review, the authors examined a cohort of COVID-positive psychiatric inpatients admitted between March and June of 2020, early in the pandemic, to Valleywise Health Medical Center (VMHC), in Arizona, USA. The goal was to assess the ways in which the virus itself as well as infection prevention and control (IPC) measures affected psychiatric inpatients.

A guillotine amputation at the ankle level-how to quickly remove a septic foot: a case report.

As of 2014, diabetes is estimated to affect 422 million people globally. It is well recognised that lower extremity amputations secondary to diabetes have a high mortality rate perioperatively. The purpose of this article is to provide a simple, step-by-step guide to surgeons who need to perform a transtibial amputation.

Nebulized Tranexamic Acid for Pediatric Post-tonsillectomy Hemorrhage: A Report of Two Cases.

Introduction: Tranexamic acid (TXA) use in pediatrics to control hemorrhage has gained interest in recent years, but there is limited literature on nebulized TXA especially regarding dosing and adverse effects. Tranexamic acid has anti-fibrinolytic properties via competitive inhibition of plasminogen activation making it a logical approach to promote hemostasis in cases of post-tonsillectomy hemorrhage.

Case Report: We describe two cases of post-tonsillectomy hemorrhage managed with nebulized TXA.

Coaxial Double-Pigtail Stent Placement: A Simple Solution to Decrease Bleeding Risk Associated With Lumen-Apposing Metal Stent?

Endoscopic cystogastrostomy using lumen-apposing metal stent (LAMS) is considered the first-line therapy for symptomatic pancreatic fluid collections (PFCs). Routine coaxial placement of a double-pigtail stent (DPS) through LAMS is debated. We report the case of a patient with delayed massive gastrointestinal bleed eight weeks after LAMS placement due to splenic artery pseudoaneurysm leading to a complicated hospitalization.

Evaluating Real-World National and Regional Trends in Definitive Closure in U.S. Burn Care: A Survey of U.S. Burn Centers.

To better understand trends in burn treatment patterns related to definitive closure, this study sought to benchmark real-world survey data with national data contained within the National Burn Repository version 8.0 (NBR v8.0) across key burn center practice patterns, resource utilization, and clinical outcomes.

Effect of Extrinsic Warming of Low-Osmolality CT Contrast Media (Iohexol 350) on Extravasations and Patient Reaction Rates: A Retrospective Study.

Extrinsic warming of iodinated CT contrast media to body temperature reduces viscosity and injection pressures. However, studies examining the effect of extrinsic warming on clinical adverse events are limited in number and provide conflicting results. Therefore, consensus practice recommendations have been sparse.

COVID-19 cardiac arrest due to Prinzmetal's angina in a previously normal heart.

In COVID-19 patients who develop sudden ST elevations it is necessary to consider cardiac causes other than myocardial infarction, such as coronary vasospasm.